77th Annual Convention and Expo Facility Registration Form

77th Annual HCANJ Convention & Expo

CENTER REGISTRATION FORM

October 28 & 29, 2025 Harrahs, Atlantic City

CENTER REGISTRATION: The registration fee is per center, NOT per staff member attending. Each registration is entitled to 14 center staff members. Each attendee must provide their name, title, individual email address, and the CEs they wish to earn.

Multi-center registration: Companies who own and/or manage more than one center may not register all centers under one community name. Each center must register independently of one another and cannot combine employees onto other registration forms.

Corporate Registration: The corporate office must register independently and pay the center registration fee as indicated below.

No registrations can be accepted after October 17.

Once registration is received, badge changes may be subject to a $50 processing fee per badge.

$700 HCANJ member center registration fee$1,800 Non-member center registration fee

$800 HCANJ member center registration fee$2,300 Non-member center registration fee

Center Name*

Center Phone Number*

Please enter a valid phone number.

Primary Contact*

Primary Contact Email*

example@example.com

Check by mail (to be mailed to 4 AAA Drive, Suite 203, Hamilton, NJ 08691)Credit card (HCANJ staff will contact you for credit card information)

Center Contact for Payment*

Name

Phone Number*

Please enter a phone number for contact for payment.

Email*

example@example.com

CENTER ATTENDEEES

Include ALL staff attending the annual convention. Each attendee MUST have their individual email. You cannot use email addresses for multiple attendees.

Administrators should register for events using the name that appears on their LNHA and/or CALA license/certificate.

Without a registration, individuals will not be admitted.

Attendee #1

First NameLast Name

Title

Email

example@example.com

NursingCALALNHANone

Attendee #2

First NameLast Name

Title

Email

example@example.com

NursingCALALNHANone

Attendee #3

First NameLast Name

Title

Email

example@example.com

NursingCALALNHANone

Attendee #4

First NameLast Name

Title

Email

example@example.com

NursingCALALNHANone

Attendee #5

First NameLast Name

Title

Email

example@example.com

NursingCALALNHANone

Attendee #6

First NameLast Name

Title

Email

example@example.com

NursingCALALNHANone

Attendee #7

First NameLast Name

Title

Email

example@example.com

NursingCALALNHANone

Attendee #8

First NameLast Name

Title

Email

example@example.com

NursingCALALNHANone

Attendee #9

First NameLast Name

Title

Email

example@example.com

NursingCALALNHANone

Attendee #10

First NameLast Name

Title

Email

example@example.com

NursingCALALNHANone

Attendee #11

First NameLast Name

Title

Email

example@example.com

NursingCALALNHANone

Attendee #12

First NameLast Name

Title

Email

example@example.com

NursingCALALNHANone

Attendee #13

First NameLast Name

Title

Email

example@example.com

NursingCALALNHANone

Attendee #14

First NameLast Name

Title

Email

example@example.com

NursingCALALNHANone

Thank you for taking the time to complete this form.

Each individual will pick up their badges at registration.

ID may be required.

We look forward to seeing you at our show!

Questions? Please contact debbie@hcanj.org

By submitting this form, I agree to pay the fees to attend the HCANJ Annual Convention and Expo.

CANCELLATIONS/REFUND POLICY HCANJ reserves the right to cancel any program for which registration fees are received. When HCANJ cancels a program and rescheduling fails, all registration fees are refunded in full. A 50% refund will be offered for cancellations made at least 30 days in advance. After that time, HCANJ regrets that we are unable to offer refunds for canceled registrations or no-shows, nor can we offer credit for future programs. If the originally registered individual is unable to attend the program, we encourage substitution from the same facility.

Please check one: